Table 1.

Typology of mistreatment of women during facility-based childbirth⁸⁵ and relevant human rights

Third order	Second order	First order	Relevant human rights
Physical abuse	Use of force	Beaten, slapped, kicked, and pinched during delivery	Right to be free from violence Right to be free from torture and other ill-treatment Right to non-discrimination Right to health Right to privacy (including physical and mental integrity) Right to be free from practices that harm women and girls Right to information Right to decide the number, spacing, and timing of children
	Physical restraint	Physically restrained to the bed or gagged during delivery
Sexual abuse	Sexual abuse	Sexual abuse or rape
Verbal abuse	Harsh language	Harsh or rude language
		Judgmental and accusatory comments
	Threats and blaming	Threats of withholding treatment or poor outcomes
		Blaming for poor outcomes
Stigma and discrimination	Discrimination based on socio-demographic characteristics	Discrimination based on sex and/or gender __________________________________ Discrimination based on ethnicity/race/religion	Right to non-discrimination Right to be free from torture and other ill-treatment Right to health Right to decide the number, spacing, and timing of children Right to information
		Discrimination based on age
		Discrimination based on socio-economic status
	Discrimination based on medical conditions	Discrimination based on HIV status
Failure to meet professional standards of care	Lack of informed consent and confidentiality	Lack of informed consent process	Right to privacy Right to health Right to non-discrimination Right to be free from violence Right to information Right to decide the number, spacing, and timing of children Right to be free from torture and other-ill treatment
		Breaches of confidentiality
	Physical examinations and procedures	Painful vaginal exams
		Refusal to provide pain relief
		Performance of unconsented surgical operations
	Neglect and abandonment	Neglect, abandonment, and long delays
		Skilled attendant absent at time of delivery
Poor rapport between women and providers	Ineffective communication	Poor communication	Right to privacy Right to information Right to non-discrimination Right to be from torture and other ill-treatment
		Dismissal of women’s concerns
		Language and interpretation issues
		Poor staff attitudes
	Lack of supportive care	Lack of supportive care from health workers
		Denial or lack of birth companions
	Loss of autonomy	Women treated as passive participants during childbirth
		Denial of food, fluids, and mobility
		Lack of respect for women’s preferred birth positions
		Denial of safe traditional practices
		Objectification of women
		Detainment in facilities
Health systems conditions and constraints	Lack of resources	Physical condition of facilities	Right to privacy Right to health Right to information Right to non-discrimination Right to and effective remedy
		Staffing constraints
		Staffing shortages
		Supply constraints
		Lack of privacy
	Lack of policies	Lack of redress
	Facility culture	Bribery and extortion
		Unclear fee structures
		Unreasonable requests of women by health workers